Individual
DR. MICHAEL T MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9155 SW BARNES RD, STE 205, PORTLAND, OR 97225-6629
(503) 297-5581
(503) 297-1421
Mailing address
9155 SW BARNES RD, STE 230, PORTLAND, OR 97225-6629
(503) 445-3235
(503) 790-2293
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19293
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003335018
REGENCE BLUE CROSS OF OR
OR
05
—
071704
—
OR
01
—
110187067
RAILROAD MEDICARE/PALMETT
OR
Enumeration date
11/01/2006
Last updated
05/27/2008
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